Overcoming post-traumatic stress

ACHIEVEMENT: After a long haul Sarah Hardiman has overcome post traumatic stress disorder.

Most young people spend time in their late teens and early 20s at parties, pubs and clubs - probably a little more time than they would care to admit.

But for Sarah Hardiman that period of growing up was largely spent locked in her house, held there in the grip of post-traumatic stress disorder (PTSD).

''I struggled to even go out of the house to collect the mail,'' Hardiman, 22, says. ''I was pretty much housebound except when I went to work.''

Her condition developed after a terrifying and random attack in the city only days before the then 17-year-old was due to sit her HSC.

She was in a car with her boyfriend when a group of men drove up next to them, and started swearing at her, calling her a ''whore'' and a ''slut''. She ignored them, but it only made the abuse worse.

''They threw a water bottle first, then it started being bottles of alcohol,'' she said.

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Another car arrived. More shouting. Broken glass everywhere. They drove as fast as they could, and got away. When she looked down she saw part of a broken bottle was sticking from her abdomen.

Hardiman was lucky to escape with relatively minor physical injuries. But the psychological injuries changed her life. It wasn't until a year ago that she managed to find the support she needed to get back on track.

Survivors of trauma were often stuck with substandard care for what was a complex condition, said Richard Bryant, Scientia Professor in the school of psychology at the University of NSW who has recently been awarded a AU$10.6 million (NZ$11.5m) grant to examine the effects of PTSD.

Professor Bryant said Australian medical authorities and businesses could be unthinkingly spreading PTSD among people who have suffered trauma by forcing them into treatments that make their problems worse in a bid to provide the ''support'' that would prevent them being sued by the injured person.

Professor Bryant said research showed that often people who suffered long-term effects of trauma had not just experienced it in the first instance, but again with repeated poor treatment from a range of sources.

In Hardiman's case, she didn't receive medical assistance after the injury, and was forced to sit her HSC days later, with no special support. ''It wasn't considered extreme enough,'' she says.

Professor Bryant said callous treatment by authorities, or inappropriate ''alternative'' treatments from untrained practitioners could all potentially contribute to making PTSD worse.

''Providing very early intervention within a day of the trauma is still the modal form of intervention by government and non-government agencies in the Western world, and we know it can be toxic,'' he said. ''It can cause more harm than good.''

Standard ''debriefing'' sessions could stimulate a stress reaction. ''What we know is this can then serve a role of over-consolidating the trauma memory and that actually compounds the stress response,'' he said.

He believed it would be only when people started suing companies for providing such ''debriefing'' sessions that the medico-legal tide would turn in the other direction.

Hardiman said she was happy to have finally received evidence-based treatment that involved ''cognitive behavioural therapy'' to help retrain her brain's fear response.

''I lost the ability to trust people, and part of the treatment was learning to trust people again,'' she said. ''It has been amazing, just the freedom to do things like go shopping whenever I want.''